无创机械通气治疗急性左心衰竭患者疗效观察.docVIP

无创机械通气治疗急性左心衰竭患者疗效观察 　　[摘要] 目的 观察无创机械通气治疗急性左心衰竭的疗效。 方法 选择我院急诊监护室2010年1月～2014年6月收治的急性左心衰竭患者86例，随机分为观察组及对照组，每组43例；观察组在传统药物治疗基础上给予无创呼吸机治疗，对照组给予传统药物治疗及吸氧。比较治疗4 h后两组患者的心率、呼吸频率、动脉血气指标及临床疗效情况。 结果 两组治疗前后的心率、呼吸频率、氧分压、血氧饱和度的差异均有统计学意义（均P0.01）；观察组的治疗效果显著优于对照组（均P0.01）；观察组的总有效率显著高于对照组（P0.05）。 结论 无创机械通气治疗能迅速改善急性左心衰竭患者的症状并纠正低氧血症，疗效显著。 　　[关键词] 无创机械通气；急性左心衰竭；疗效 　　[中图分类号] R541.6 [文献标识码] B [文章编号] 1673-9701（2015）15-0099-03 　　[Abstract] Objective To observe the curative effects of noninvasive mechanical ventilation in the treatment of acute left heart failure. Methods All 86 patients with acute left heart failure who were admitted to EICU in our hospital from January 2010 to June 2014 were selected. They were randomly assigned to observation group and control group， with 43 patients in each group； the observation group was given noninvasive ventilator on the basis of conventional medical treatment， and the control group was given conventional medical treatment and oxygen uptake. Heart rate， respiratory rate， ABG index and clinical effects between the two groups 4 hours after the treatment were compared. Results The differences of heart rate， respiratory rate， oxygen partial pressure and oxygen saturation before and after the treatment in the two groups were both statistically significant（P0.01）； curative effects in the observation group were significantly better than those in the control group， and the difference was statistically significant（P0.01）； the difference of total effective rate in the two groups was statistically significant（P0.05）. Conclusion Noninvasive mechanical ventilation is able to rapidly improve the symptoms of acute left heart failure and correct hyoxemia， which has significant curative effect. 　　[Key words] Noninvasive mechanical ventilation； Acute left heart failure； Curative effects 　　急性左心衰竭是内科常见的急危重症，是由于心脏解剖或功能突发异常使心肌收缩力明显减弱，心脏负荷显著增高，致心脏排血量在短时间内急骤下降，肺循环压力明显上升从而引起的临床综合征，以急性肺水肿或心源性休克为主要表现[1]。患者突发严重的呼吸困难、强迫坐位、烦躁不安、咳粉红色泡沫样痰、口唇发绀、大汗淋漓、心率加快、两肺广泛湿??音及哮鸣音、心尖部奔马律等，